Hip orthotic with a removable rigid brace assembly

ABSTRACT

A hip joint orthotic that can be used in stages. In the first stage the orthotic includes a stiff relatively brace assembly that can limit the amount of allowed flexion, extension, abduction, and adduction. In the second stage the relatively stiff brace can be removed and the orthotic can be used as a soft wrap. In both stages the orthotic is configured to easily mount and retain a thermal pack in a desired position or positions. In many instances the thermal pack will be a cold pack, but in some cases a hot pack may be used as well.

CROSS-REFERENCES TO RELATED APPLICATIONS

This application is a continuation-in-part of pending U.S. patentapplication Ser. No. 16/160,092. The parent application was filed onOct. 15, 2018. It remains pending.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not Applicable.

MICROFICHE APPENDIX

Not Applicable

BACKGROUND OF THE INVENTION 1. Field of the Invention

This invention relates to the field of medical products. Morespecifically, the invention comprises a hip brace that is configured toposition and retain thermal transfer packs, among other things.

2. Description of the Related Art

Hip replacement surgery is often an open procedure requiring arelatively large incision. Significant tissue displacement is requiredduring the preparation and insertion of an artificial joint. In recentyears arthroscopic hip surgery has become increasingly common, and thishas reduced the wound size and tissue disruption. Whether an open orclosed procedure, it is generally important after such a surgery tocontrol the motion of the hip joint. It is also desirable in manyinstances to provide cold therapy in order to reduce inflammation. Thepresent invention addresses both these concerns as well as additionalconcerns.

BRIEF SUMMARY OF THE PRESENT INVENTION

The present invention provides a hip joint orthotic that can be used instages. In the first stage the orthotic includes a relatively stiffbrace assembly that can limit the amount of allowed flexion, extension,abduction, and adduction of the hip joint. In the second stage therelatively stiff brace can be removed and the orthotic can be used as asoft wrap. In both stages the orthotic is configured to easily mount andretain a thermal pack in a desired position or positions. In manyinstances the thermal pack will be a cold pack, but in some cases a hotpack may be used as well.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

FIG. 1 is a perspective view showing the brace assembly used in thepresent invention.

FIG. 2 is a perspective view, showing the operation of the slide bodyused in the brace assembly of FIG. 1 .

FIG. 3A is a perspective view, showing the operation of the pivotmechanism in the brace assembly.

FIG. 3B is a perspective view, showing the operation of a slide jointbetween the upper link and the upper plate

FIG. 3C is a sectional view, showing the operation of the sliding jointbetween the upper link and the upper plate.

FIG. 4 is a perspective view, showing the union of the brace assemblyand the panel assembly.

FIG. 5 is a detailed view, showing an adjustable coupling.

FIG. 6A is a perspective view showing a sheave assembly.

FIG. 6B is a sectional elevation view through one of the sheave bodiesshown in FIG. 5 .

FIG. 7 is a perspective view, showing the invention installed on a user.

FIG. 8 is a perspective view, showing how the brace assembly and thepanel assembly are united in a particular embodiment.

FIG. 9 is a perspective view, showing how the upper thigh strap can becut to length.

FIG. 10 is a perspective view, showing a user putting on the inventiveorthotic.

FIG. 11 is a perspective view, showing how the lower thigh strap can becut to length.

FIG. 12 is a perspective view, showing a thermal pack configured for usein the present invention.

FIG. 13 is an elevation view, showing the inward facing side of theassembled orthotic.

FIG. 14 is a perspective view, showing the inventive orthotic in aninstalled state.

FIG. 15 is a plan view, showing a completed panel assembly for apneumatic embodiment of the invention.

FIG. 16 is a sectional elevation view through the panel assembly of FIG.15 .

FIG. 17 is a perspective view, showing a user wearing the inventiveorthotic with the brace assembly omitted.

FIG. 18 is a perspective view, showing an embodiment of the inventiveorthotic with a removable brace assembly.

FIG. 19 is a perspective view, showing the assembly of FIG. 18 with thebrace assembly removed.

FIG. 20 is a detailed sectional view, showing one approach to detachablyconnecting the removable brace assembly.

FIG. 21 is a detailed sectional view, showing another approach todetachably connecting the removable brace assembly.

FIG. 22 is a detailed elevation view, showing another approach todetachably connecting the removable brace assembly.

FIG. 23 is a detailed sectional view, showing another approach todetachably connecting the removable brace assembly.

FIG. 24 is a detailed sectional view, showing the embodiment of FIG. 23in an assembled state.

REFERENCE NUMERALS IN THE DRAWINGS

-   -   10 brace assembly    -   12 pivot mechanism    -   14 flexion stop    -   16 extension stop    -   18 lock    -   20 upper link    -   22 upper plate    -   24 abduction pivot    -   26 lower link    -   28 lower plate    -   30 slide body    -   32 slide release    -   34 thigh belt plate    -   36 upper plate cover    -   38 waist panel    -   40 thigh panel    -   42 waist strap    -   44 upper thigh strap    -   46 lower thigh strap    -   48 soft backing    -   50 belt buckle    -   52 central web    -   54 sheave assembly    -   56 adjustment tab    -   57 adjustment tab    -   58 cord    -   60 sheave body    -   62 groove    -   64 coupler    -   66 user    -   68 receiver    -   70 release button    -   72 hook panel    -   73 hook panel    -   74 adjustable coupling    -   80 leg    -   82 pocket    -   84 hook panel    -   86 removed length    -   87 tang    -   88 hook panel    -   90 thermal pack    -   91 pneumatic panel assembly    -   92 sealed perimeter    -   93 squeeze bulb    -   94 hook panel    -   95 release    -   96 air valve    -   97 adjustable coupling    -   98 hook tab    -   100 edge band    -   102 seam    -   104 air bladder    -   106 outer layer    -   110 anchor plate    -   112 sheave body    -   114 center section    -   116 slot    -   120 frame    -   122 cord anchor    -   124 cord anchor    -   126 slot    -   128 slide rivet    -   130 lower link    -   132 upper link    -   134 fastener    -   136 captive nut    -   138 hole    -   140 offset bracket    -   142 grip disk    -   144 insert    -   146 contact pad    -   148 hook panel    -   150 hook panel    -   152 hook panel    -   154 hook panel    -   156 relief    -   158 notch    -   160 prong    -   162 hole    -   164 polymer lower plate    -   166 retaining ring    -   168 insert    -   170 captive nut

DETAILED DESCRIPTION OF THE INVENTION

The inventive orthotic includes a rigid brace assembly, a flexible panelassembly, and several belts and adjustment devices. FIGS. 1-3 depictbrace assembly 10. Upper link 20 is connected to lower link 26 by pivotmechanism 12. Upper link 20 is intended to run roughly parallel to theuser's torso while lower link 26 is intended to run roughly parallel tothe user's thigh.

Upper plate 22 is connected to the upper portion of upper link 20. Theupper plate is preferably curved to conform to the user's lateral pelvicarea. Lower plate 28 is connected to lower link 26. The lower plate ispreferably curved to conform to the user's outer thigh. Both the upperand lower plates may be made of soft metal so that a technician canadjust their curvature to suit a particular individual.

Pivot mechanism 12 may be a variety of mechanisms that are known in thefield. In the version show, lock 18 can be set to eliminate any pivotingmotion between the upper and lower link. Flexion stop 14 and extensionstop 16 can be moved to a desired position in order to limit the flexionor extension of the hip joint.

Abduction pivot 24 is provided to allow the hip to move in abductionover a small range. Slide body 30 slides up and down along lower link 26in order to reposition thigh belt plate 34 and the thigh belt that isattached thereto. FIG. 2 shows this feature in motion. In the versionshown the user presses inward on a pair of slide releases 32 and movesslide body 30 downward while holding the slide releases in. Once theslide body reaches the desired position the user allows the two slidereleases to pop outward and this action then locks the slide body inplace. Many different locking mechanisms can be used to allow andrestrain the motion of the slide body.

FIG. 3A shows the brace assembly with pivot mechanism 12 in an unlockedstate. Lower link 26 is free to pivot with respect to upper link 20. Therange of available motion can be set by the flexion and extension limitsdescribed previously.

FIGS. 3B and 3C show an embodiment in which an additional degree offreedom is provided between upper link 20 and upper plate 22. A verticalslot 126 is provided in the upper portion of upper link 20. Two sliderivets 128 are connected to upper plate 22. These slide rivet (which mayassume various forms) move with upper plate 22 but slide freely withinslot 126. FIG. 3C provides a section view through these components. Thereader will note how slide rivets 128 connect upper link 20 and upperplate 22, but allow the upper plate to slide freely over the upper link(subject to the upper and lower boundaries of the slot. Multi-componentfasteners may be substituted for the simplistic slide rivets shown.

Returning now to FIG. 3B, the reader will understand that upper plate 22is free to slide up and down with respect to upper link 20—subject tothe limits of slot 126. This feature allows the inventive orthotic to bemore comfortable when a user takes a sitting position—as will bedescribed subsequently.

FIG. 4 shows the brace assembly, the panel assembly, and othercomponents assembled to form an example of the inventive orthotic. Thepanel assembly includes waist panel 38, thigh panel 40, and central web52 (which links the waist panel and the thigh panel). Pivot mechanism 12lies roughly over the location of central web 52. Upper link lies overthe center of waist panel 38 (with the upper plate of the upper linklying under upper plate cover 36). Lower link 26 lies primarily overthigh panel 40.

Waist strap 42 has a first end secured to the left portion of waistpanel 38 (“left” being understood with respect to the orientation shownin FIG. 4 ). A second end of the waist strap is free. Upper thigh strap44 extends across most of thigh panel 40. A first end of the upper thighstrap is secured to lower link 26 and a second end of the upper thighstrap is free.

Thigh belt plate 34 is connected to the lower end of slide body 30. Softbacking 48 lies beneath the thigh belt plate and prevents discomfort forthe user. Lower thigh strap 46 is engaged through loops in the thighbelt plate. In the version shown, belt buckle 50 is provided on a firstend of the lower thigh belt while the second end of the belt is free.

Two sheave assemblies 54 are shown in FIG. 4 . These form part of anadjustment mechanism for closing and adjusting the length of the waiststrap and the upper thigh strap. The upper sheave assembly 54 ispreferably sewn or otherwise connected to waist panel 38. The lowersheave assembly 54 is preferably sewn or otherwise connected to one endof upper thigh strap 44.

FIGS. 5, 6A, and 6B show additional details regarding the sheaveassemblies and the adjustment mechanisms they form part of FIG. 5 showsa detail view of adjustable coupling 74 as applied to waist strap 42.The sheave assembly 54 on the left side of the view is attached to waistpanel 38. A second sheave assembly 54 is attached to (or molded as partof) coupler 64. In this example each sheave assembly 54 includes fourseparate sheaves 60.

Coupler 64 is releasably connected to receiver 68. Receiver 68 isconnected to hook panel 72. Hook panel 72 is connected at a desiredposition to the outward facing surface of the free end of waist strap42. The outward facing surface of the waist strap is covered with loopmaterial (Throughout this disclosure the term “loop material” isintended to mean a material that can receive and engage a hook panel.Those skilled in the art will know that many modern loop materials aresmooth and the fact that they are hook-compatible is not immediatelyobvious. Modern loop materials are often not “fuzzy” like the loopmaterials of past years). The inward facing surface of hook panel 72 iscovered in hook material, so that hook panel 72 will stick to theoutward facing surface of the waist strap wherever it is pressed intoposition.

FIG. 6A shows a detailed view of a sheave assembly 54. Each individualsheave includes a sheave body 112 in a corresponding frame 120. In theexample shown each frame 120 has four connecting legs 80. Each sheavebody 112 also includes a center section 114 that passes across a slot116. Cord 58 passes through slot 116 and around center section 114. Eachsheave body thereby acts like a pulley. It is not necessary for thesheave bodies to actually rotate in the frames. As long as centersection 114 is a relatively low-friction material cord 58 can slideeasily through as the device is adjusted.

In the example shown frames 120 and anchor plate 110 are molded as oneintegral piece of plastic. Each sheave body 112 is pressed into positionin a corresponding relief in a frame 120. Anchor plate 110 is preferablymade thin enough so that a heavy gauge needle can pass through it andsew it to a portion of a belt or the panel assembly. Alternatively, thesheave assembly can be molded as part of a larger molded clasp or otherfeature.

FIG. 6B shows a section through one of the sheave bodies and frames.Groove 62 is preferably incorporated into center section 114. Thisgroove helps to control the location of cord 58 as it passes around thecenter section.

Returning now to FIG. 5 the operation of the adjustment mechanism willbe explained. The reader will observe that the two sheave assemblies 54oppose each other across a gap. Cord 58 is one continuous piece with twofree ends. The first free end of the cord is secured to coupler 64 atcord anchor 122. The second free end is secured to coupler 64 at cordanchor 124. Adjustment tab 56 includes a hollow transverse passage andcord 58 passes through this as shown. The adjustment tab is preferablyable to slide freely along the cord.

The cord is able to slide freely through each of the sheave bodies. Theassembly shown operates like a block-and-tackle. If the user pullsadjustment tab 56 toward the right the two sheave assemblies 54 arepulled closer together with a considerable mechanical advantage.Adjustment tab 56 includes hook material on its inward facing surface.The outward facing side of hook panel 72 and waist strap 42 are coveredin loop material. Once the desired level of tension for the waist strapis obtained by pulling the adjustment tab, the user presses theadjustment tab against the hook panel and/or waist strap and the hookand loop engagement secures the adjustment tab in position.

The embodiment depicted in FIG. 5 includes an additional helpfulfeature. Coupler 64 can be selectively disengaged from receiver 68 bypressing release button 70. The coupler can be reconnected to thereceiver by sliding the two components together. When first donning theorthotic adjustment tab 56 can be left dangling. The user first connectsthe belt by snapping coupler 64 into receiver 68. The user then adds thedesired level of tension by pulling adjustment tab 56 to the right andsecuring it in place.

FIG. 7 shows the inventive orthotic installed on user 66. Waist strap 42is passed around the user's waist and secured using adjustable coupling74. Upper thigh strap 44 is passed around the user's upper thigh andsecured using adjustable coupling 97. Slide body 30 is extended to thedesired position and lower thigh strap 46 is then passed around theuser's lower thigh. The lower thigh strap preferably includes loopcovering on its inward and outward facing surfaces. This strap is passedthrough belt buckle 50. Hook panel 76 is then pressed over the end ofthe belt and back on the body of the belt to secure it in position asshown.

Adjustment tab 56 is lifted and moved to adjust the desired tension ofwaist strap 42. Adjustment tab 57 is lifted and moved to adjust thedesired tension of upper thigh strap 44. A relatively low tension isapplied with the position of adjustable tab 57 shown in FIG. 7 . In manyinstances the user will pull the adjustment tab over lower link 26 andattach it posteriorly to lower link 26. Hook panel 76 is lifted andmoved to adjust the desired tension of lower thigh strap 46.

The reader will note that pivot mechanism 12 is placed in line with theflexion extension axis of the hip joint. The thin central web 52 of thepanel assembly allows the panel assembly to bend with the pivotmechanism when the hip joint is flexed. This allows the desiredpost-surgical adjustment of the range of motion while also providingdesired stability.

The reader will recall from FIG. 3B that in some embodiments of thepresent invention upper plate 22 is free to move up and down withrespect to upper link 20. When a user goes from a standing position(such as shown in FIG. 7 ) to a sitting position the distance betweenthe waist strap 42 and upper portion of waist panel 38 and pivotmechanism 12 will be shortened. Absent some accommodation for thisphenomenon, the waist strap and upper portion of the panel assembly willassume an odd angle on the user and will become uncomfortable. Thetelescoping relationship between upper plate 22 and upper link 20accommodates this variation by allowing upper plate 22 to move downwardwith respect to upper link 20 when the user sits. When the user againstands upper plate 22 will move back to its normal position with respectto the upper link (as shown in FIG. 7 ).

FIG. 8 illustrates one process for the assembly of the inventiveorthotic. Upper plate cover 36 is sewn to waist panel 38 around threeedges but the bottom edge remains open to form pocket 82. Upper plate 22slides into pocket 82 as indicated by the arrow. The outward facingsurface of waist panel 38 (the side facing the viewer in FIG. 8 ) iscovered in loop material. Two hook tabs 98 are provided with inwardfacing hook panels. Once upper plate 22 is secure within pocket 82, thetwo hook tabs 98 are pressed against waist panel 38, thereby securingthe upper plate within the pocket. Additional hook panels are preferablyplaced on the inward facing side of upper plate 22 (such as by using ahigh-bond adhesive tape). These additional hook panels directly engagethe loop material on waist panel 38.

Upper thigh strap 44 is secured to lower link 26 by any suitable method.The attachment could be made by rivets, by stitching, by adhesive, or byreleasable plastic connectors. It is preferable for upper thigh strap 44to be removable from lower link 26 for reasons which will be describedsubsequently.

Upper thigh strap 44 is positioned to overlie lower plate 28 as shown.The upper thigh strap also includes a pair of hook panels 84 (onepositioned just outside each of the two lateral extremes of the lowerplate). The outward facing surfaces of the panel assembly are preferablyall covered in loop material (waist panel 38, central web 52 and thighpanel 40). Once the brace assembly is in position, the user pushes thecentral portion of upper thigh belt 44 down against the panelassembly—causing the two hook panels 84 to engage. This—in conjunctionwith the upper plate being held within pocket 82—effectively locks thebrace assembly to the panel assembly. The reader should note that mostof adjustable coupling 97 is omitted in FIG. 8 for purposes of visualclarity. FIG. 4 shows the invention in an assembled state.

It is preferable for all the straps employed to be adjustable in lengthover a wide range. One option is to provide straps that can be trimmedto length. FIG. 9 shows a configuration allowing this. The length ofupper thigh strap 44 is shortened by cutting away removed length 86.Hook panel 72 (which is attached to receiver 68) is then pressed intoposition on the outward facing surface near the newly formed end ofupper thigh strap 44. The same operation can be performed for the waiststrap.

FIG. 11 shows an even simpler operation that can be used for lower thighstrap 46. The thigh strap is equipped with loop material on both itsinward and outward facing surfaces. The lower thigh strap 46 is passedthrough belt buckle 50 and drawn to the desired position. Any excesslength is then cut free. The inward facing surface of hook panel 88includes hook material. The hook panel is pressed into place as shown,with approximately half of the hook panel covering the free end of thelower thigh strap and half covering the body of the thigh strap. Oncepressed into place, hook panel 88 secures the desired tension. However,hook panel 88 is easily removed in order to release the lower thighstrap.

FIG. 10 shows the customary first stage in applying the inventiveorthotic. Waist panel 38 is placed proximate the affected hip and waiststrap 42 is passed around the user's waist. Tang 87 on coupler 64 slidesinto receiver 68 where it snaps into place. The user may then place adesired amount of tension on the waist strap using tab 56.

The same process is repeated for upper thigh strap 44. The user secureslower thigh strap 46 by passing its free end through belt buckle 50 andthen securing the lower thigh strap back on itself (using a hook panel)as described previously. The result is shown in FIG. 7 . The user isable to individually adjust the tension on the waist strap, upper thighstrap, and lower thigh strap by moving adjustment tab 56, adjustment tab57, and hook panel 76 (respectively).

An important advantage of the present invention is its ability to securea thermal pack or packs against the body in the areas affected by hipsurgery. The provision of cold therapy is particularly desirable. FIG.12 depicts thermal pack 90. In the example of FIG. 12 , thermal transferpack 90 includes two liquid-impermeable layers joined together along asealed perimeter 92 to create an enclosed volume. Valve 96 provides acontrolled passage from the exterior to the interior. The interiorcontains a heat transfer medium. This is preferably a hydrating liquidconsisting of a solution of water and a humectant selected from thegroup consisting of propylene glycol, ethylene glycol, glycerin,dimethyl sulfoxide, dimethyl formamide, and combinations thereof.

When this substance transitions to a solid it expands to a form that issimilar to packed snow or crushed ice. As a result the cold pack remainssoft and malleable even when in a frozen state. Air is admitted to theinterior through valve 96 during the freezing process. When the mediummelts valve 96 allows air out of the enclosed interior but not theliquid medium.

Hook panels 94 are provided to attach thermal transfer pack 90 to theinward facing surface of the present invention—as will be explained.Each pack has an inward facing surface and an outward facing surface.The outward facing surface includes the hook panels. The inward facingsurface is intended to face the user when the pack is in use. The inwardfacing surface preferably includes a layer of cover material. The covermaterial is preferably a soft and compliant material that may becomfortably worn against the user's thin clothing (such as a T-shirt) oreven directly against the user's skin. This material preferably wicksmoisture away from the user as well. The cover material may be bonded tothe thermal transfer pack by any suitable method—including adhesives orstitching. It is preferable for the side facing the user to have noexposed discontinuities as these may be irritating.

The cooling media within the pack may be subdivided into many small bags(“sub-bags”) contained within the larger volume. These “sub-bags” may besmall—on the order of 1 to 2 inches square. The cooling media containedwithin the overall interior of thermal pack 90 is preferably a substancesuch as shown in U.S. Pat. No. 5,800,491 to Kolen and Nebolon. Thissubstance forms an organized crystalline solid with a consistencysimilar to snow. Even as a solid, it remains soft and malleable.However, the substance such as disclosed in the '491 Patent does notabsorb as much energy during the transition from a solid to a liquid aspure water. Water can absorb more thermal energy, yet water has anundesirable property in that it solidifies into a hard mass (ice). Ifthermal pack 90 were simply filled with water and frozen, the resultwould be a rigid object that would be quite uncomfortable to wear. It istherefore desirable to provide a duplex construction of a large bag withmany smaller sub-bags. The sub-bags contain pure water, or nearly so.The volume within the thermal pack as a whole but outside the sub-bagscontains a substance such as shown in Kolen and Nebolon. Readers wishingto know more detail concerning this structure are referred to U.S.patent application Ser. No. 15/645,206. U.S. patent application Ser. No.15/645,206 is hereby incorporated by reference.

The use of sub-bags within the larger volume provides the advantageouslatent heat of water while retaining most of the beneficial aspects ofthe substance described in the '491 Patent. Each sub-bag is filled withwater. Small amounts of other substances may be present as well, butwater is by far the main constituent. The volume contained within theinterior of the thermal pack but outside the sub-bags is filled with asubstance that creates a snow-like solid (such as described in the '491Patent). The result is an advantageous combination of features. Eachindividual sub-bag freezes into a hard object (containing ice). Thesurrounding volume freezes into a malleable snow-like substance. Thesub-bags are relatively small—preferably less than 3 cm on a side andeven more preferably less than 2 cm on a side. Thus, the overall thermalpack can still bend and flex because the sub-bags can move about withinthe snow-like frozen substance surrounding them. The user employs thecomposite thermal pack in the same way. However, the composite nature ofthe bag allows a greater absorption of thermal energy for the same unitvolume.

In some versions of the composite thermal transfer bag the sub-bags orouter bag can include a thermochromatic material. This material changescolor when the media freezes—thereby clearly indicating to the userwhether all the sub-bags are fully transitioned to a solid. In someversions a thermochromatic ink may be added to the water within thesub-bags. In other versions, the thermochromatic material will be a filmadded to the sub-bags, the overall bag, or both. FIG. 13 shows anexemplary application of multiple thermal packs to the inventiveorthotic. FIG. 13 depicts the inward-facing side of the orthotic(“inward” meaning the side intended to face the user). The inward facingsurface of waist panel 38, central web 52, and thigh panel 40 arecovered with loop material. Thermal packs 90 are positioned as shown.Each thermal pack is then attached to the inward facing surface of thepanel assembly by pressing the hook panels on the thermal packs againstthe loop covering on the panel assembly. The resulting engagement holdsthe thermal packs in place, even when the orthotic is lifted andmanipulated as part of the process of placing the orthotic on the user.

On the other hand, if a user wishes to move one of the thermal packs, itis a simple matter of peeling it off and sticking it in a new location.This will be done regularly, as the thermal packs must be swapped forreplacement packs every few hours. It is common for a user to keep oneset of packs in the freezer while a second set of packs is being worn.Once the set of packs being worn has transitioned back to a liquidstate, the user swaps the packs for the set in the freezer. It isdesirable to make the orthotic easy to remove and reattach. Manyfeatures are provided on the orthotic to accommodate this desire.

FIGS. 14-17 illustrate an additional embodiment of the inventiveorthotic. It is desirable with the use of thermal packs to provideadditional inward compressive force in order to force the packs tightlyagainst the body. This inward compression causes the packs to conform tothe user's exterior surface and enhance heat transfer.

FIG. 14 shows the additional embodiment being worn by a user. The panelassembly in this version is equipped with an internal air bladder.Squeeze bulb 93 is used to selectively inflate this air bladder. Thesqueeze bulb is connected to the air bladder by a one-way valve. Everytime the user squeezes the squeeze bulb the pressure within the airbladder increases. If the user wishes to decrease the pressure withinthe air bladder, he or she presses release 95.

In operation the orthotic is donned (usually with a thermal pack orpacks in place). The user then adjusts the waist strap, upper thighstrap, and lower thigh strap to provide a good fit. The user thensqueezes squeeze bulb 93 until the desired level of compression isreached. When the time comes to remove the orthotic, the user pressesrelease 95 and then unlatches the three straps (waist, upper thigh, andlower thigh).

FIG. 15 shows the panel assembly as modified by the inclusion of theinternal air bladder. The panel assembly is designated as pneumaticpanel assembly 97. Its structure is similar to the panel assembly usedin the embodiment of FIG. 4 . Squeeze bulb 93 and release 95 are addedin a convenient location. In addition, numerous seams 102 are added toorganize the internal air bladder in a desired fashion. These seamssubdivide the air bladder into a series of semi-tubular chambers,resulting in a structure similar to that of an “air mattress.”

FIG. 16 shows a sectional elevation view taken through the region ofcentral web 52. Air bladder 104 is the innermost layer. This is coveredby a fabric outer layer 106. Edge band 100 is sewn around the perimeterof the panel assembly. The air bladder is sealed around the outerperimeter. The air bladder is also sealed along seams 102. These can becreated by pressing the material along the seam together and fusing thefour layers where they contact (such as by “heat staking” or ultrasonicwelding). The user wishing to know more about the details ofconstructing the air bladder and the seams is referred to U.S. Pat. No.9,750,630, which is hereby incorporated by reference.

Returning to FIG. 14 , the operation of removing the inventive orthoticwill be described in detail. The user starts by pressing release 95 todeflate the air bladder. The user next pulls free adjustment tab 56,adjustment tab 57, and hook panel 76 (see FIG. 7 ). The user thenpresses the release button 70 in each of the adjustable couplings 74,97. The orthotic may then be pulled free and laid on a surface with itsinward facing side facing upward—such as depicted in FIG. 13 . The userthen pulls the thermal packs 90 free and replaces them with a fresh set.The orthotic is then donned as described previously.

As mentioned previously, the inventive orthotic has two main components(the brace assembly and the panel assembly). It is possible to separatethe brace assembly so that the panel assembly can be used without thebrace assembly. As a patient progresses after surgery, the use of therigid brace assembly may no longer be needed (such as when a restrictionon the range of motion is no longer needed). However, these patients maydesire to continue using thermal packs as part of rehabilitation.

Looking again at FIG. 8 , the process of removing the brace assemblywill be described. In the example shown, the user starts by pulling thetwo hook panels 84 free of the loop covering on thigh panel 40. The userthen lifts the brace assembly up and away from thigh panel 40. The userthen pulls the two hook panels 98 free from waist panel 38 and slidesupper plate 22 down and out of pocket 82.

At this point the brace assembly is free from the panel assembly.However, the user will recall that upper thigh strap 44 is connected tolower link 26 of the brace assembly. It is desirable to use the upperthigh strap with the panel assembly, so it must first be detached fromthe brace assembly. If detachable fasteners are used to attach the upperthigh strap to lower link 26 then these are simply detached. Ifstitching is used for the attachment then the stitching will have to becut. Whatever approach is taken, upper thigh strap 44 is preferablyseparated from the brace assembly. Once separated, the upper thigh strapcan be connected to thigh panel 40 by pressing the two hook panels 84against the loop covering on the exterior of the thigh panel. The panelassembly can then be used as a compressive orthotic with waist strap 42and upper thigh strap 44 (but without lower thigh strap 46).

FIG. 17 shows the orthotic in this state applied to user 66. One or morethermal packs are typically attached before the orthotic is donned.Waist strap 42 can be tightened to a desired degree using adjustablecoupling 74. Likewise, upper thigh strap 44 can be tightened to adesired degree using adjustable coupling 97. The user then pressessqueeze bulb 93 to inflate the internal air bladder to a desiredpressure. The orthotic may be removed as desired for replacement of thethermal packs.

In some applications it is desirable to repetitively remove and replacethe brace assembly. For example, the presence of the brace assembly maybe desirable for exercise periods but undesirable for rest periods.Accordingly, it is beneficial to provide embodiments in which the braceassembly can be easily removed from the panel assembly (the softportions of the brace) and subsequently reattached.

FIG. 18 shows a first embodiment of the inventive orthotic with theeasily removable brace assembly. The removable brace is similar to theversion shown in FIG. 1 . Upper link 132 is pivotally connected to lowerlink 130 by pivot mechanism 12. Slide body 30 is slidably connected tolower link 130. In this detachable embodiment, however, four fasteners134 connect the brace assembly to the panel assembly. Two fasteners 134connect lower link 130 to a lower plate connected to thigh panel 40. Twoadditional fasteners 134 connect upper link 132 to an upper platecontained within upper plate cover 36.

Fasteners 134 may assume a wide variety of forms, including screws,quarter-turn fasteners, bayonet-lug fasteners, and sliding links. Thefasteners depicted in FIG. 18 are metal machine screws with an enlargedplastic head. The enlarged head facilitates gripping and removal withoutthe need for a separate tool.

FIG. 19 shows the same assembly in an exploded state. Fasteners 134 havebeen unscrewed and pulled free of holes 138 in upper link 132 and lowerlink 130. Hook panel 76 has been pulled free and lower thigh strap 46has been removed from the leg. The entire brace assembly has thus beenpulled free from the panel assembly (the soft portion of the inventiveorthotic). Two captive nuts 136 are retained in offset bracket 140 nearthe top of the waist panel. Two additional captive nuts 136 are retainedin the vicinity of thigh panel 40. The upper two captive nuts receivethe fasteners for upper link 132. The lower two captive nuts receive thefasteners for lower link 130. The reader will thereby perceive that auser can easily reattach the brace assembly by inserting each fastener134 through a hole 138 and into a captive nut 136.

FIGS. 20-24 provide additional details regarding exemplary hardware thatis used to attach the removable brace assembly to the soft portions ofthe orthotic. Returning briefly to FIG. 1 , the reader will recall thatthe non-removable version of the brace assembly includes upper plate 22and lower plate 28. Looking now at FIG. 8 , the reader will recall thatlower plate 28 is typically secured to thigh panel 40 and upper plate 22is typically secured to waist panel 38. The embodiments incorporatingthe removable brace assembly preferably still provide a lower plateattached to the thigh panel and an upper plate attached to the waistpanel. It is preferable for the two plates 22, 28 to remain with thepanel assembly when the brace assembly is removed.

FIG. 20 provides a detailed sectional view through thigh panel 40 withthe removable brace assembly installed. The section plane is takenthrough the central bore of one of the captive nuts 136. As for thenon-removable examples, lower panel 28 is secured between thigh panel 40and upper thigh strap 44. Hook panels 148, 150 on the inward-facing sideof lower panel 28 engage the outward-facing hook-compatible surface onthigh panel 40.

Captive nut 136 is secured to lower panel 28. In this example the lowerpanel is made of metal—such as soft aluminum. Captive nut 136 is swagedinto a hole in the metal and thereby secured. Many different types ofcaptive nuts can be used. A good example is a “PEM” nut as supplied byPenn Engineering and Manufacturing of Danboro, Pa., U.S.A.

The exemplary captive nut shown has a threaded internal bore and acylindrical exterior that extends outward beyond the outward facingsurface of lower panel 28 and beyond upper thigh strap 44 (A clearancehole is provided through the upper thigh strap).

Lower link 130 includes two holes 138 (seen clearly in FIG. 19 ). Eachhole is sized to be a close sliding fit over the protruding cylindricalexterior of captive nut 136. FIG. 20 shows lower link 130 secured tocaptive nut 136 by sliding a hole 138 in lower link 130 over thecylindrical exterior of captive nut 136. Fastener 134 is then used toclamp lower link 130 firmly in place.

In the example shown, fastener 134 has a metal insert 144 and anovermolded polymer grip disk 142. Insert 144 includes a threadedprotrusion that threads into captive nut 136. Grip disk 142 ispreferably made large enough for a user to manually grasp andtighten/loosen fastener 134 without the need for a tool.

Fastener 134 includes an annular contact pad 146. As the user grasps andturns grip disk 142, annular contact pad 46 presses against lower link(over a broad area) and urges it toward lower panel 28. The engagementshown in FIG. 20 is repeated for two locations (the two holes 138 inlower link 130). Lower link 130 is thereby positively located by theengagement of the two holes 138 and captive nuts 136. Lower link 130 isheld in place via the compression provided by the two fasteners 134.

In the example of FIG. 20 , grip disk 142 is bonded to insert 144 via anovermolding process. The two components may be bonded by othermeans—such as through the use of an adhesive. Of course, one could alsomake the two components 142, 144 as a single integral unit.

The junction shown in FIG. 20 can also be used for the two fastenerssecuring upper link 132. However, the reader will recall that the upperlink and upper plate optionally include a sliding joint between theupper link and the upper plate. An example of this sliding joint isshown in FIGS. 3B and 3C. It is preferable for the implementation of thedetachable brace assembly to accommodate such a sliding joint.

Looking against at FIG. 19 , the reader will note that the captive nuts136 used to secure upper link 132 are not directly attached to the upperplate. Rather—in the example shown in the view—they are attached tooffset bracket 140. A section view through one of the captive nuts 136in offset bracket 140 is shown in FIG. 21 .

In the example of FIG. 21 , upper plate 22 is secured between waistpanel 38 and upper plate cover 36. Hook panels 152, 154 secure theinward-facing surface of upper plate 22 to the outward-facinghook-compatible surface of waist panel 38.

Offset bracket 140 is slidably secured to upper plate 22 by slide rivet128 (The operation of the slide rivet has previously been explained). Inthis example offset bracket 140 is made from a piece of hollowrectangular tubing (The use of the word “tubing” in the descriptive term“rectangular tubing” may seem to be a contradiction in terms, but it isthe standard term used for hollow thin-walled metal stock). Captive nut136 is swaged into the outward-facing side of offset bracket 140. Therivet nut contains a female threaded bore. It also contains acylindrical exterior that protrudes outward well beyond theoutward-facing surface of offset bracket 140. One of the holes 138 inupper link 132 is sized to be a close sliding fit over the cylindricalexterior of the rivet nut—as shown. Once upper link 132 is in place,fastener 134 is threaded into rivet nut 136. Upper link 132 is therebysecured against offset bracket 140. However, the sliding connection ispreserved (via the fact that offset bracket 140 can slide with respectto upper plate 22). Additional holes can be provided in the offsetbracket to permit the introduction of a bucking bar or squeeze jaw thatmay be needed to install the slide rivets.

The lateral offset (with respect to the hip) provided by offset bracket140—if sized correctly—can eliminate the need for an offsetting “dogleg”in upper link 132. Returning to FIG. 19 , the reader will note thatwhile upper link 132 still has an angular dogleg, it lacks a lateraldogleg (compare to the version shown in FIG. 7 ).

It is possible to provide a molded plastic embodiment for the panels 22,28. FIGS. 22-24 illustrate this embodiment. FIG. 22 shows an elevationview of lower link 130 in the vicinity of upper thigh strap 44. Apolymer lower plate is contained between upper thigh strap 44 and thighpanel 44. Two reliefs 156 are provided in upper thigh strap 44 so thatportions of the polymer lower plate can protrude outward. Theseportions—prongs 160—include inward-facing points. Lower link 130includes four lateral notches 158 configured to receive theseinward-facing points of prongs 160 as shown. The engagement of prongs160 and notches 158 locates lower link 130 with respect to the polymerlower plate. Two holes 162 are also provided in lower link 130 toreceive fasteners.

In FIG. 22 , the section plane for the sectional view of FIG. 23 is“called out.” FIG. 23 shows a sectional view with lower link 130 beingseparated from the panel assembly. Polymer lower plate 164 is securedbetween thigh panel 40 and upper thigh strap 44. Hook panels 148, 150 onthe inward-facing side of the polymer lower plate engage thehook-compatible outward-facing surface of thigh panel 40.

The polymer lower plate is curved to provide a good fit against theuser. Prongs 160 extend outward as shown. Captive nut 170 in thisexample is a molding insert. Its outer cylindrical surface is knurled.It is placed in the mold and thermoplastic material is then shot aroundthe insert. Its knurled exterior surface locks the insert to the polymerlower plate. Captive nut 170 includes a female-threaded central bore, asshown.

Lower link 130 is shown in the detached position. The section is takesthrough the middle of a pair of notches 158 in lower link 130 (Thenotches are shown in FIG. 22 ). The reader will note how the width ofthe lower link between the two notches can fit between the two prongs160.

It is desirable for fasteners 134 to remain attached to the braceassembly when the brace assembly is removed, in order to prevent theirloss. In the example of FIG. 23 , insert 168 includes a retaining ring166 as shown. The retaining ring lies on the same side of the insert asthe threaded shaft that is configured to thread into captive nut 170.The opposite end of insert 168 is bonded to a large polymer grip disk.The bonding between insert 168 and the grip disk can be done via anovermolding process or an adhesive bonding process.

Another exemplary approach is to screw the insert into an ultrasonicwelding machine so that the insert becomes a “horn” for ultrasonicallymelting a thermoplastic. The insert is places through the holes 162 inlower link 130. The outward portion of insert 168 is placed at the startof a pilot hole molded into the grip disk. The ultrasonic weldingmachine is then activated and the insert is driven into the grip diskand thereby bonded to the grip disk.

It is also possible to create retaining ring 166 by providing a groovein the exterior of the insert and installing a circlip or e-clip.Whatever method is used, the reader will appreciate that fastener 134remains attached to the brace assembly when the brace assembly isdetached from the panel assembly. Fastener 134 remains free to rotatewith respect to lower link 130, however. The approach shown in FIG. 23can also be applied to the embodiment of FIG. 18-21 .

FIG. 24 shows the same sectional view as FIG. 23 —but after fastener 134has been threaded into captive nut 170 and tightened. The reader willobserve how lower link 130 has been drawn securely between the twoprongs 160 and thereby secured.

A similar configuration can be used for a polymer upper plate. Lookingback at FIG. 21 , those skilled in the art will know that a polymerversion of upper plate 22 and offset bracket 140 can be provided. Theuse of a molded polymer would also allow the creation of a slidingconnection without the need for a separate slide rivet.

The features thus described can be combined and altered in many ways.Exemplary modifications include:

1. Attaching the detachable brace assembly to the panel assembly usinghook-and-loop fasteners;

2. Employing fasteners 134 to connect the brace assembly to thigh panel40 but using the engagement of upper plate 22 and upper plate cover 36(as depicted in FIG. 8 ) to provide the detachable connection for theupper link.

3. Providing a detachment system where the plates stay with the braceassembly.

4. Providing a lanyard connecting each fastener to the brace assembly sothat loose fasteners are not lost.

5. Providing a storage pocket for the fasteners on the panel assembly.

Although the preceding descriptions present considerable detail theyshould be properly viewed as illustrating embodiments of the presentinvention rather than limiting the scope of the invention. Many moreembodiments following the same principles will occur to those skilled inthe art. Accordingly, the scope of the invention should be fixed by thefollowing claims rather than by the examples given.

The invention claimed is:
 1. A hip orthotic configured to attach to auser's lateral waist, hip, and lateral thigh, comprising: (a) a panelassembly, including, (i) a waist panel configured to lie over saiduser's lateral waist, including a first protrusion extending outwardfrom said waist panel, a second protrusion extending outward from saidwaist panel, said second protrusion being offset from said firstprotrusion, (ii) a thigh panel configured to lie over said user'slateral thigh, including a third protrusion extending outward from saidthigh panel, a fourth protrusion extending outward from said thighpanel, said fourth protrusion being offset from said third protrusion,(iii) a central web between said waist panel and said thigh panelconfigured to lie over said user's hip, (iv) a waist strap configured toencircle said waist of said user and secure said waist panel to saiduser, (v) an upper thigh strap configured to encircle said thigh of saiduser and secure said thigh panel to said user, (b) a brace assembly,including, (i) an upper link, (ii) a lower link, (iii) a pivot mechanismbetween said upper link and said lower link; (c) said upper linkincluding a first hole, and a second hole offset from said first hole;(d) said first and second holes being sized and positioned so that saidfirst hole is a close sliding fit over said first protrusion and saidsecond hole is a close sliding fit over said second protrusion, therebypositively locating said upper link with respect to said waist panelwhen said first hole is slid over said first protrusion and said secondhole is slid over said second protrusion; (i) said lower link includinga third hole, and a fourth hole laterally offset from said third hole;and (j) said third and fourth holes being sized and positioned so thatsaid third hole is a close sliding fit over said third protrusion andsaid fourth hole is a close sliding fit over said fourth protrusion,thereby positively locating said lower link with respect to said thighpanel when said third hole is slid over said third protrusion and saidfourth hole is slid over said fourth protrusion; (k) a first threadedhole proximate said first protrusion; (l) a second threaded holeproximate said second protrusion; (m) a third threaded hole proximatesaid third protrusion; (n) a fourth threaded hole proximate said fourthprotrusion; (o) a first fastener passed through said first hole in saidupper link and into said first threaded hole; (p) a second fastenerpassed through said second hole in said upper link and into said secondthreaded hole; (q) a third fastener passed through said third hole insaid lower link and into said third threaded hole; and (r) a fourthfastener passed through said fourth hole in said lower link and intosaid fourth threaded hole.
 2. The hip orthotic as recited in claim 1,comprising: (a) wherein said panel assembly has an inward facing sidewith a loop covering; (b) a thermal transfer bag configured to attach tosaid loop covering on said inward facing side of said panel assembly,said thermal transfer bag including, (i) a sealed interior volumecontaining heat transfer media, (ii) an outward facing surface having ahook panel configured to engage said loop covering on said inward facingside of said panel assembly, and (iii) an inward facing surface coveredin a soft and compliant fabric.
 3. The hip orthotic as recited in claim1, wherein: (a) an attachment between said upper link and said upperpanel includes an offset bracket; and (b) said offset bracket includesan inward-facing side that is slidably connected to said upper panel. 4.The hip orthotic as recited in claim 1, wherein each of said protrusionsand said threaded holes are part of a captive nut.
 5. The hip orthoticas recited in claim 1, wherein said third and fourth fasteners areconfigured to remain connected to said lower link when said lower linkis removed from said lower panel.
 6. The hip orthotic as recited inclaim 1, wherein said first and second fasteners are configured toremain connected to said upper link when said upper link is removed fromsaid upper panel.
 7. A hip orthotic configured to attach to a user'slateral waist, hip, and lateral thigh, comprising: (a) a waist panelconfigured to lie over said user's lateral waist, including, (i) anupper plate, (ii) an offset bracket slidably connected to said upperplate, (iii) a first protrusion extending outward from said offsetbracket, (iv) a second protrusion extending outward from said offsetbracket, said second protrusion being offset from said first protrusion;(b) a thigh panel configured to lie over said user's lateral thigh,including, (i) a lower plate, (ii) a third protrusion extending outwardfrom said lower plate, (iii) a fourth protrusion extending outward fromsaid lower plate, said fourth protrusion being offset from said thirdprotrusion; (c) a central web between said waist panel and said thighpanel configured to lie over said user's hip, said waist panel, thighpanel, and central web in combination forming a panel assembly; (d) awaist strap configured to encircle said waist of said user and securesaid waist panel to said user; (e) an upper thigh strap configured toencircle said thigh of said user and secure said thigh panel to saiduser; (f) a brace assembly, including, (i) an upper link, (ii) a lowerlink, (iii) a pivot mechanism between said upper link and said lowerlink; (g) said upper link including a first hole, and a second holeoffset from said first hole; (h) said first and second holes being sizedand positioned so that said first hole is a close sliding fit over saidfirst protrusion and said second hole is a close sliding fit over saidsecond protrusion, thereby positively locating said upper link withrespect to said offset bracket when said first hole is slid over saidfirst protrusion and said second hole is slid over said secondprotrusion; (i) said lower link including a third hole, and a fourthhole laterally offset from said third hole; (j) said third and fourthholes being sized and positioned so that said third hole is a closesliding fit over said third protrusion and said fourth hole is a closesliding fit over said fourth protrusion, thereby positively locatingsaid lower link with respect to said lower plate when said third hole isslid over said third protrusion and said fourth hole is slid over saidfourth protrusion; (k) a first threaded hole proximate said firstprotrusion; (l) a second threaded hole proximate said second protrusion;(m) a third threaded hole proximate said third protrusion; (n) a fourththreaded hole proximate said fourth protrusion; (o) a first fastenerpassed through said first hole in said upper link and into said firstthreaded hole; (p) a second fastener passed through said second hole insaid upper link and into said second threaded hole; (q) a third fastenerpassed through said third hole in said lower link and into said thirdthreaded hole; and (r) a fourth fastener passed through said fourth holein said lower link and into said fourth threaded hole.
 8. The hiporthotic as recited in claim 7, comprising: (a) wherein said waist paneland said thigh panel both have an inward facing side with a loopcovering; (b) a thermal transfer bag configured to attach to said loopcovering, said thermal transfer bag including, (i) a sealed interiorvolume containing heat transfer media, (ii) an outward facing surfacehaving a hook panel configured to engage said loop covering on saidinward facing side of said panel assembly, and (iii) an inward facingsurface covered in a soft and compliant fabric.
 9. The hip orthotic asrecited in claim 7, wherein each of said protrusions and said threadedholes are part of a captive nut.
 10. The hip orthotic as recited inclaim 7, wherein said third and fourth fasteners are configured toremain connected to said lower link when said lower link is removed fromsaid lower plate.
 11. The hip orthotic as recited in claim 7, whereinsaid first and second fasteners are configured to remain connected tosaid upper link when said upper link is removed.